Physiotherapy delivery systems-clinical and microbiological effectiveness in the treatment of chronic periodontitis

Abstract

Relevance . Currently, the symbiotic microflora of the oral cavity plays an increasing role in the occurrence of periodontitis. Frequent use of modern medications for the treatment of patients with chronic generalized periodontitis is not the most effective therapy. One of the reasons for the low effectiveness of treatment can be considered long-term use of antibacterial drugs that lead to the development of dysbiosis in the oral cavity and immune imbalance. In order to improve the quality of periodontal treatment, dentists successfully use physical therapy. It is known that the diode laser has a high therapeutic efficiency, its use leads to a rapid subsiding of acute inflammatory phenomena, stimulation of reparative (recovery) processes, improvement of tissue microcirculation, normalization of the General immune system, and increased resistance (stability) of the body. Ozone generators used for dental treatment have a beneficial effect on periodontal tissues. Therapeutic ozone has: immunostimulating, bactericidal, fungicidal, anti-inflammatory, detoxifying and other properties. Purpose . The goal is to study the antibacterial effect of physiotherapy methods with local delivery of exposure agents. Materials and methods . We examined 80 patients with chronic generalized periodontitis of moderate severity, who, depending on the physiotherapy method used in the complex treatment of periodontitis, were divided into 2 groups of 40 people each: the first group used the Picasso led laser, and the second group used the Ozonedta device with combined local exposure to darsonvalization and ozone. The microbiological composition of periodontal pockets was determined before and after physical therapy. To isolate the aerobic microflora, we used the method of sector crops according to Gold (1965) with the calculation of the number of microorganisms in the obtained material. Anaerobes were identified by PCR using the «Multident» kit. The clinical effectiveness of the studied physiotherapy methods was evaluated 12 months after two courses of treatment (once every 6 months) using index indicators that characterize the state of periodontal tissues (PMA, CPI, Green-Vermillion, PPP, PDI, and the degree of gum recession). Results . After exposure to the Picasso diode laser, the number of aerobic microorganisms sown decreases, but not significantly. While the number of aerobic microorganisms significantly decreased after exposure to the «Ozonedta» device (P ≤ 0.001). The titer of the anaerobic microflora studied after exposure to the «Picasso» diode laser on the periodontal pocket changed in the direction of reducing the content of microorganisms by an average of 2 times, and after treatment with the ozone generator «Ozone DTA Generator» in the second group decreased by an average of 4.8 times. After 12 months of maintenance therapy, all clinical indices decreased significantly in both groups, especially the PMA index in the group where the «Ozonedta» device was used. Conclusion . Physiotherapy methods performed using the Picasso diode laser and the «Ozonedta» device for the treatment of periodontitis allow to obtain an antibacterial effect by non-drug local delivery of exposure agents in patients with chronic generalized periodontitis and significantly reduce the signs of inflammation in the periodontal tissues.